The strong African American families-teen trial: rationale, design, engagement processes, and family-specific effects.

This study addresses two limitations in the literature on family-centered intervention programs for adolescents: ruling out nonspecific factors that may explain program effects and engaging parents into prevention programs. The Rural African American Families Health project is a randomized, attention-controlled trial evaluating the efficacy of the Strong African American Families-Teen (SAAF-T) program, a family-centered risk-reduction intervention for rural African American adolescents. Rural African American families (n = 502) with a 10th-grade student were assigned randomly to receive SAAF-T or a similarly structured, family-centered program that focused on health and nutrition. Families participated in audio computer-assisted self-interviews at baseline and 6-month follow-up. Program implementation procedures yielded a design with equivalent doses, five sessions of family-centered intervention programming for families in each condition. Of eligible families screened for participation, 76% attended four or five sessions of the program. Consistent with our primary hypotheses, SAAF-T youth, compared to attention-control youth, demonstrated higher levels of protective family management skills, a finding that cannot be attributed to nonspecific factors such as aggregating families in a structured, interactive setting.

Mechanisms of Family Impact on African American Adolescents' HIV-Related Behavior.

A longitudinal model that tested mediating pathways between protective family processes and HIV-related behavior was evaluated with 195 African American youth. Three waves of data were collected when the youth were 13, 15, and 19 years old. Evidence of mediation and temporal priority were assessed for three constructs: academic engagement, evaluations of prototypical risk-taking peers, and affiliations with risk-promoting peers. Structural equation modeling indicated that protective family processes assessed during early adolescence were associated with HIV-related behavior during emerging adulthood and that academic engagement, evaluations of prototypical risk-taking peers, and affiliations with risk-promoting peers accounted for this association. Evidence of a specific pathway emerged: protective family processes → academic engagement negative → evaluations of prototypical risk-taking peers→ affiliations with risk-promoting peers→ HIV-related behavior. Academic engagement also was a direct predictor of HIV-related risk behavior.

Risk and protective factors for unprotected intercourse among rural African American young adults.

OBJECTIVES: Despite increasing risk for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), few data are available concerning the factors associated with risky sexual behavior among African American young adults who do not attend college. Additionally, the possibility that different risk mechanisms affect men and women remains understudied. This article reports on the risk and protective factors associated with unprotected intercourse and gender differences in these factors' influence among this group. Predictors were derived from ecological and self-regulatory theories of risk behavior. METHODS: African Americans aged 18-21 years were recruited via respondent-driven sampling (RDS) from seven contiguous rural counties. Risk and protective factors for unprotected intercourse were analyzed for 214 of 292 participants who reported sexual intercourse during the past three months. RESULTS: Among sexually active participants, 62.6% used condoms inconsistently. The influence of leaving the parental home, perceived discrimination, risk-taking peers, family relationships, risk-taking propensity, and binge drinking on unprotected intercourse were moderated by gender. Positive attitudes toward condom use were associated with less unprotected intercourse controlling for the influence of risk variables for both men and women. CONCLUSIONS: Men and women have unique STI prevention needs. Additional research addressing these needs is necessary, particularly for rural African American men.

Identifying supportive and unsupportive responses of others: perspectives of African American and Caucasian cancer patients.

This study uses focus group methodology to examine supportive and unsupportive responses experienced by African American and Caucasian cancer patients. Supportive responses included practical assistance, as well as people's willingness to listen, maintain a positive attitude, and pray. Unsupportive responses included others' withdrawal behaviors, patients having to support friends/family as they coped, and family/friends limiting patients' independence. Results reflect ways in which mental health providers, social workers, and health care providers can help patients express support needs, as well as how social networks can be better educated about the types of support valued by patients.